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9 <br /> <br />EXHIBIT A <br />FORM RESIDENTIAL RELEASE <br /> <br />PROPERTY DAMAGE RELEASE <br /> <br />Property Address: ___________________________________ Everett, Washington. <br /> <br />The undersigned, ____________________, being of lawful age and for the sole <br />consideration of ____________________ dollars ($__________) (the “Settlement <br />Amount”), for the undersigned and for the undersigned’s executors, heirs, administrators, <br />marital community, agents, successors and assigns, and on behalf of any other person <br />having a claim or right in the property located at the address shown above, hereby <br />releases, acquits and forever discharges the City of Everett, Hos Brothers, and each of <br />their past, present and future agents, servants, employees, administrators, representatives, <br />insurers (including without limitation American Alternative Insurance Corp. (“AAIC”)), <br />heirs and successors of and from any and all claims, actions, causes of action, demands, <br />rights, damages, costs, loss of service, expenses and compensation of any nature <br />whatsoever that the undersigned now has or that may hereafter accrue, whether based on <br />a tort, contract, statutory or other theory of recovery, arising from or in any way related <br />to an occurrence on or about February 3, 2023 at or near the address shown above, <br />including without limitation all claims asserted in Tort Claim No. __________ filed with <br />the City of Everett. The undersigned acknowledges and agrees that the release set forth <br />above is a general and global release. <br />The undersigned expressly waives and releases any and all claims for damages that may <br />exist as of the effective date of this release, but that the undersigned does not know of or <br />suspect to exist, and which, if known, would materially affect the undersigned’s decision <br />to enter into this settlement. <br />The undersigned directs that the City of Everett pay the Settlement Amount as <br />follows: $__________ to ____________________. <br />The undersigned is solely responsible for paying all costs, materials, contractor and <br />materialmen fees, and lien claims for work, labor and material set forth and relate to <br />Tort Claim No. . <br />It is understood and agreed that this settlement and payment of the Settlement Amount <br />are not to be construed as an admission of liability by any parties hereby released, and <br />that said releasees expressly deny liability to the undersigned and intend merely to <br />avoid litigation. <br />[signature on following page]